Organization
SACRED HEART PHC,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA RENEE GONZALEZ LVN (ADMINISTRATOR)
(361) 834-3526
Entity
Organization
Contact information
Practice address
103 W GRAVIS ST, SAN DIEGO, TX 78384-2639
(361) 279-8280
(361) 279-4128
Mailing address
103 W GRAVIS ST, SAN DIEGO, TX 78384-2639
(361) 279-8280
(361) 279-4128
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
016703
TX
Other
Enumeration date
04/06/2015
Last updated
07/07/2015
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